BACKGROUND:The pelvis has abundant trabecular bone content,but the ability of conventional sacroiliac percutaneous fixation to control trabecular bone is limited,leading to fixation failure.Therefore,the development of devices that can more effectively control trabecular bone tension is of significant importance.OBJECTIVE:The mechanical properties of a novel sacroiliac tension screw were investigated using biomechanical testing and numerical modeling analysis,along with an assessment of the reliability of the pull-out force numerical model.METHODS:A mechanical model was established based on the working principle of the novel sacroiliac tension screw.Numerical methods were employed to analyze its pull-out performance,validated through mechanical testing with polyurethane material to assess the reliability of the pull-out force numerical model.Using pelvic specimens,the mechanical effectiveness of the novel sacroiliac tension screw in repairing sacroiliac joint injuries was analyzed under normal standing posture,along with an evaluation of the load stiffness of different pelvic models in the standing position.RESULTS AND CONCLUSION:(1)The average error between the computed values of the numerical model and the measured values was 13.19％,indicating a certain level of validity for the numerical model.(2)The damage to the polyurethane material after the extraction of the screw was less pronounced in the novel screw group.(3)The average effective holding displacement for the novel screw was approximately(9.24±0.27)mm,significantly greater than the average displacement of(1.71±0.57)mm observed with the lag screws.However,the maximum resistance to pullout for the lag screws was significantly higher than that for the novel screws.(4)The novel screw effectively repaired sacroiliac joint injuries.(5)The stiffness after repair of sacroiliac joint injuries was equivalent when using a single novel screw compared to using two lag screws.(6)These results prove that the theoretical model for the maximum resistance to pullout of the screws established in this study has a certain level of validity and can guide the design of them with improved mechanical performance.The novel sacroiliac spiral blade screw can effectively hold trabecular bone and has practical clinical utility.

Objective:To analyze the biological parameters of the anterior segment of age-related cataracts patients with or without zonular weakness with the new generation of sweep-source anterior optical coherence tomography (OCT) device CASIA2 to provide a basis for the diagnosis of zonular weakness.Methods:A case-control study was conducted.A total of 158 cases (186 eyes) of patients with age-related cataracts having zonular weakness as a zonular weakness group, and 80 cases (80 eyes) of cataract with age-related cataracts without zonular weakness as a normal zonule group were enroll from June 2022 to June 2023 at Beijing Tongren Hospital.All patients underwent routine preoperative ophthalmological examination including slit lamp microsopy, IOLMaster 700, ocular B-ultrasound and OCT.The anterior chamber depth (ACD), anterior chamber volume (ACV), lens thickness (LT), lens vault (LV), anterior chamber angle opening distance at 750 μm (AOD750), lens decentration and tilt, radius of curvature of the anterior lens surface (RAL), and radius of curvature of the posterior lens surface (RPL) of patients were measured with CASIA2 and compared between the two groups.The relationship between zonular weakness and anterior chamber parameters and lens parameters was evaluated by logistic regression analysis.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital (No.TRECKY2018-049), and all enrolled patients signed the informed consent form.Results:In the zonular weakness group, ACD, ACV, RAL, and AOD750 were (2.34±0.56)mm, (85.05±40.19)mm 3, 7.52 (7.13, 8.08)mm, and 0.27 (0.07, 0.30)mm, respectively, which were smaller than (3.13±0.38)mm, (127.75±38.15)mm 3, 9.28(8.51, 9.76)mm, and 0.52 (0.31, 0.65)mm in the normal zonule group, with statistically significant differences (all P<0.05).LT and LV in the zonular weakness group were (5.14±0.45)mm and (1.22±0.53)mm, respectively, which were larger than (4.27±0.52)mm and (0.32±0.30)mm in the normal zonule group, and the differences were statistically significant (both P<0.05).Magnitude of lens decentration and tilt in the zonular weakness were 0.34 (0.13, 0.45)mm and 6.44 (3.67, 7.32)°, respectively, which were significantly larger than 0.19 (0.12, 0.25)mm and 4.88 (3.85, 5.65)° in the normal zonule group (both P<0.05).No obvious pattern was found in the direction of decentration and tilt.Logistic regression analysis showed that LV and lens decentration were risk factors of zonular weakness (odds ratios [ OR]=706.170, 335.339; both P<0.05), and RAL was a protective factor of zonular weakness ( OR=0.239, P<0.05). Conclusions:Age-related cataract patients with zonular weakness often present with a decrease in ACV due to increased anterior convexity of the lens.Decreased RAL, increased lens decentration and elevated LV are risk factors for zonular weakness.

Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

Objective:To analyze the biological parameters of the anterior segment of age-related cataracts patients with or without zonular weakness with the new generation of sweep-source anterior optical coherence tomography (OCT) device CASIA2 to provide a basis for the diagnosis of zonular weakness.Methods:A case-control study was conducted.A total of 158 cases (186 eyes) of patients with age-related cataracts having zonular weakness as a zonular weakness group, and 80 cases (80 eyes) of cataract with age-related cataracts without zonular weakness as a normal zonule group were enroll from June 2022 to June 2023 at Beijing Tongren Hospital.All patients underwent routine preoperative ophthalmological examination including slit lamp microsopy, IOLMaster 700, ocular B-ultrasound and OCT.The anterior chamber depth (ACD), anterior chamber volume (ACV), lens thickness (LT), lens vault (LV), anterior chamber angle opening distance at 750 μm (AOD750), lens decentration and tilt, radius of curvature of the anterior lens surface (RAL), and radius of curvature of the posterior lens surface (RPL) of patients were measured with CASIA2 and compared between the two groups.The relationship between zonular weakness and anterior chamber parameters and lens parameters was evaluated by logistic regression analysis.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital (No.TRECKY2018-049), and all enrolled patients signed the informed consent form.Results:In the zonular weakness group, ACD, ACV, RAL, and AOD750 were (2.34±0.56)mm, (85.05±40.19)mm 3, 7.52 (7.13, 8.08)mm, and 0.27 (0.07, 0.30)mm, respectively, which were smaller than (3.13±0.38)mm, (127.75±38.15)mm 3, 9.28(8.51, 9.76)mm, and 0.52 (0.31, 0.65)mm in the normal zonule group, with statistically significant differences (all P<0.05).LT and LV in the zonular weakness group were (5.14±0.45)mm and (1.22±0.53)mm, respectively, which were larger than (4.27±0.52)mm and (0.32±0.30)mm in the normal zonule group, and the differences were statistically significant (both P<0.05).Magnitude of lens decentration and tilt in the zonular weakness were 0.34 (0.13, 0.45)mm and 6.44 (3.67, 7.32)°, respectively, which were significantly larger than 0.19 (0.12, 0.25)mm and 4.88 (3.85, 5.65)° in the normal zonule group (both P<0.05).No obvious pattern was found in the direction of decentration and tilt.Logistic regression analysis showed that LV and lens decentration were risk factors of zonular weakness (odds ratios [ OR]=706.170, 335.339; both P<0.05), and RAL was a protective factor of zonular weakness ( OR=0.239, P<0.05). Conclusions:Age-related cataract patients with zonular weakness often present with a decrease in ACV due to increased anterior convexity of the lens.Decreased RAL, increased lens decentration and elevated LV are risk factors for zonular weakness.

Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

BACKGROUND:The pelvis has abundant trabecular bone content,but the ability of conventional sacroiliac percutaneous fixation to control trabecular bone is limited,leading to fixation failure.Therefore,the development of devices that can more effectively control trabecular bone tension is of significant importance.OBJECTIVE:The mechanical properties of a novel sacroiliac tension screw were investigated using biomechanical testing and numerical modeling analysis,along with an assessment of the reliability of the pull-out force numerical model.METHODS:A mechanical model was established based on the working principle of the novel sacroiliac tension screw.Numerical methods were employed to analyze its pull-out performance,validated through mechanical testing with polyurethane material to assess the reliability of the pull-out force numerical model.Using pelvic specimens,the mechanical effectiveness of the novel sacroiliac tension screw in repairing sacroiliac joint injuries was analyzed under normal standing posture,along with an evaluation of the load stiffness of different pelvic models in the standing position.RESULTS AND CONCLUSION:(1)The average error between the computed values of the numerical model and the measured values was 13.19％,indicating a certain level of validity for the numerical model.(2)The damage to the polyurethane material after the extraction of the screw was less pronounced in the novel screw group.(3)The average effective holding displacement for the novel screw was approximately(9.24±0.27)mm,significantly greater than the average displacement of(1.71±0.57)mm observed with the lag screws.However,the maximum resistance to pullout for the lag screws was significantly higher than that for the novel screws.(4)The novel screw effectively repaired sacroiliac joint injuries.(5)The stiffness after repair of sacroiliac joint injuries was equivalent when using a single novel screw compared to using two lag screws.(6)These results prove that the theoretical model for the maximum resistance to pullout of the screws established in this study has a certain level of validity and can guide the design of them with improved mechanical performance.The novel sacroiliac spiral blade screw can effectively hold trabecular bone and has practical clinical utility.

Objective To investigate the curative effect of early hemoperfusion(HP)in treating patients with sepsis.Methods Early stage sepsis patients admitted to the First People's Hospital of Nanyang City Affiliated to Henan University from January 2020 to December 2022 were selected as the research subjects.These patients were randomly divided into experimental group(62 patients)and control group(31 patients).Early bundle therapy combined with continuous renal replacement therapy(CRRT)were used in both groups as the standard treatment,but only the standard treatment was used in control group.Based on the treatment of control group,the patients in experimental group were treated with HP,the"2-2-1"plan(on the first and second days,connecting resin HP device HA380 in series every 12 hours,and connecting one perfusion device in series on the third day)was applied.The white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukins(IL-6,IL-10),the hemodynamic indicators(systolic blood pressure,diastolic blood pressure),lactic acid(Lac),sequential organ failure assessment(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ),and the difference in intensive care unit(ICU)hospitalization time of the patients before admission and after 3 day treatment were compared between the two groups.The Kaplan-Meier method was used to draw survival curves and the difference in 28-day survival rates was compared between the two groups.Results After 3 days of treatment,the inflammatory indexes TNF-α,IL-6,IL-10,PCT,CRP,WBC and SOFA score,APACHEⅡscore,Lac in the experimental group all decreased significantly(all P<0.05).In the control group,only the PCT and CRP indexes significantly decreased compared with those before treatment(both P<0.05).Compared with the control group,the difference before and after the change of PCT,CRP,IL-6,IL-10 and SOFA score,APACHEⅡscore,Lac in the experimental group were significant[PCT(μg/L):12.31(6.95,42.69)vs.3.84(1.06,14.47),CRP(mg/L):78.69±64.60 vs.31.49±81.14,IL-6(ng/L):1 357.20(243.96,7 205.50)vs.110.00(-1 749.00,1 377.00),IL-10(ng/L):36.87(5.43,1 218.80)vs.2.67(-11.00,22.79),SOFA score:5(3,7)vs.1(-3,6),APACHEⅡscore:8(5,11)vs.5(-2,7),Lac(mmol/L):3.93±2.89 vs.2.42±2.89,all P<0.05].The clearance rate of inflammatory cytokines IL-6 and IL-10 in the experimental group was higher than that in the control group(IL-6:F=17.93,P<0.001,IL-10:F=6.62,P=0.012).The Kaplan-Meier curve showed the 28-day survival rate of the experimental group was higher than that of the control group(79.03%vs.58.06%),the differences were statistically significant(Log-Rank test:χ2=4.706,P=0.030).Multivariate Cox regression analysis showed that no HP treatment,Lac level before treatment and high APACHEⅡ score were risk factors for death Conclusion HP in the early interventional treatment of sepsis can reduce the levels of inflammatory cytokines and control the inflammatory storm.The HP"2-2-1"treatment frequency can effectively improve the prognosis of septic patients and increase their survival rate.

Objective To investigate the biomechanical properties of a novel sacroiliac lag screw with a spiral blade.Methods Percutaneous sacroiliac lag screws were used as the controls.Polyurethane material was used to simulate the trabecular bone,and the pullout resistance performance was tested on an Instron mechanical testing machine.Subsequently,pelvic specimens were utilized to analyze the static stiffness and dynamic stability of the novel sacroiliac lag screw in repairing sacroiliac joint injuries under normal standing conditions,with normal pelvis,single-sided sacroiliac joint injury pelvis,percutaneous sacroiliac lag screw-single screw repair,and percutaneous sacroiliac lag screw-double screw repair as controls.Results The damage to the polyurethane material after screw extraction was smaller in the novel sacroiliac lag screw group.The average effective holding displacement of the novel sacroiliac lag screw was significantly greater than that of the percutaneous sacroiliac lag screw(P＜0.05).However,the maximum resistance to the pullout force for the percutaneous sacroiliac lag screw was significantly higher than that for the novel sacroiliac lag screw(P＜0.05).The stiffness after repair of sacroiliac joint injuries was significantly higher when using a single sacroiliac lag screw than when using two percutaneous sacroiliac lag screws(P＜0.05).The displacement amplitude was the highest in the sacroiliac joint injury group,followed by that in the normal group.The displacement amplitudes in the other groups were similar;however,the differences were statistically significant(P＜0.05).The dynamic stability of the sacroiliac lag screw repair group was the best,slightly better than that of the percutaneous sacroiliac lag screw-double screw repair group,and the dynamic stability of the sacroiliac joint injury group was the worst.The novel sacroiliac lag screw effectively repaired the sacroiliac joint injuries.Conclusions The novel sacroiliac lag screw can effectively hold the trabecular bone and has practical clinical utility.

Objective:To investigate the effects of unilateral ureteral obstruction on renal pelvic peristalsis and pacemaker cells in neonatal rats.Methods:An animal experimental study.Thirty-six 2-day-old newborn SD rats were randomly divided into the partial unilateral ureteral obstruction (PUUO) group, complete unilateral ureteral obstruction (CUUO) group, and sham operation group, with 12 rats in each group.One week after surgery, all rats were subjected to renal pelvic pressure (RPP) measurement by puncture.After measurement, the rats were euthanized, and their left renal pelvis and ureter were removed and fixed for histological examination.Parameters such as RPP, peristaltic wave frequency and amplitude at different perfusion speeds were recorded and compared, and the changes in pacemaker cells (atypical smooth muscle cells and Cajal-like interstitial cells) were also compared.The independent samples t-test was used for comparison between 2 groups, and the one-way ANOVA of variance was used for comparison among 3 groups. Results:In the sham operation group, the RPP increased gradually with the increase of perfusion speed; the frequency of peristaltic waves rose rapidly and then dropped after reaching the highest level with the increase of perfusion speed; similarly, the amplitude of peristaltic waves first increased and then decreased as the perfusion speed increased.In the PUUO group, the RPP increased rapidly with the increase of perfusion speed, higher than that in the sham operation group; the frequency of peristaltic waves was higher than that in the sham operation group, and it was relatively constant under the perfusion speed of 40 mL/h, but when the perfusion speed increased again, the frequency began to decline; the amplitude of peristaltic waves increased quickly and then declined at a faster rate than the sham operation group with the increase of perfusion speed.In the CUUO group, the basic RPP was 12 cmH 2O(1 cmH 2O=0.098 kPa); at the perfusion speed of 5 mL/h, the RPP rose gradually, and no plateau appeared; when the RPP reached 73 cmH 2O, the perfusate retrograded from the side of the puncture needle, then the RPP slightly decreased and then balanced, and no regular peristaltic waves were observed in the renal pelvis throughout the whole perfusion process.Immunofluorescence staining analysis showed the pacemaker cells were all located in the smooth muscle of the renal pelvic wall.The sham operation group had the highest positive rate, followed by the PUUO group and then the CUUO group. Conclusions:Ureteral obstruction has a significant impact on the peristalsis of the renal pelvis, and its impact on the peristaltic wave frequency and amplitude and RPP can be predicted.The reduction of pacemaker cells in the renal pelvis may be involved in the changes of renal pelvic peristalsis caused by ureteral obstruction, but further research is needed on how pacemaker cells regulate the peristalsis of the renal pelvis and ureter.

Objective To investigate the curative effect of early hemoperfusion(HP)in treating patients with sepsis.Methods Early stage sepsis patients admitted to the First People's Hospital of Nanyang City Affiliated to Henan University from January 2020 to December 2022 were selected as the research subjects.These patients were randomly divided into experimental group(62 patients)and control group(31 patients).Early bundle therapy combined with continuous renal replacement therapy(CRRT)were used in both groups as the standard treatment,but only the standard treatment was used in control group.Based on the treatment of control group,the patients in experimental group were treated with HP,the"2-2-1"plan(on the first and second days,connecting resin HP device HA380 in series every 12 hours,and connecting one perfusion device in series on the third day)was applied.The white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukins(IL-6,IL-10),the hemodynamic indicators(systolic blood pressure,diastolic blood pressure),lactic acid(Lac),sequential organ failure assessment(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ),and the difference in intensive care unit(ICU)hospitalization time of the patients before admission and after 3 day treatment were compared between the two groups.The Kaplan-Meier method was used to draw survival curves and the difference in 28-day survival rates was compared between the two groups.Results After 3 days of treatment,the inflammatory indexes TNF-α,IL-6,IL-10,PCT,CRP,WBC and SOFA score,APACHEⅡscore,Lac in the experimental group all decreased significantly(all P<0.05).In the control group,only the PCT and CRP indexes significantly decreased compared with those before treatment(both P<0.05).Compared with the control group,the difference before and after the change of PCT,CRP,IL-6,IL-10 and SOFA score,APACHEⅡscore,Lac in the experimental group were significant[PCT(μg/L):12.31(6.95,42.69)vs.3.84(1.06,14.47),CRP(mg/L):78.69±64.60 vs.31.49±81.14,IL-6(ng/L):1 357.20(243.96,7 205.50)vs.110.00(-1 749.00,1 377.00),IL-10(ng/L):36.87(5.43,1 218.80)vs.2.67(-11.00,22.79),SOFA score:5(3,7)vs.1(-3,6),APACHEⅡscore:8(5,11)vs.5(-2,7),Lac(mmol/L):3.93±2.89 vs.2.42±2.89,all P<0.05].The clearance rate of inflammatory cytokines IL-6 and IL-10 in the experimental group was higher than that in the control group(IL-6:F=17.93,P<0.001,IL-10:F=6.62,P=0.012).The Kaplan-Meier curve showed the 28-day survival rate of the experimental group was higher than that of the control group(79.03%vs.58.06%),the differences were statistically significant(Log-Rank test:χ2=4.706,P=0.030).Multivariate Cox regression analysis showed that no HP treatment,Lac level before treatment and high APACHEⅡ score were risk factors for death Conclusion HP in the early interventional treatment of sepsis can reduce the levels of inflammatory cytokines and control the inflammatory storm.The HP"2-2-1"treatment frequency can effectively improve the prognosis of septic patients and increase their survival rate.